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Anaesthetic considerations for strabismus surgery in children and adults.
Chua, Alfred Wy; Chua, Matthew J; Leung, Harry; Kam, Peter Ca.
Afiliación
  • Chua AW; Department of Anaesthetics, Royal Prince Alfred Hospital, Sydney, Australia.
  • Chua MJ; Department of Intensive Care Medicine, Nepean Hospital, Sydney, Australia.
  • Leung H; Department of Ophthalmology, Sydney Children's Hospital, Sydney, Australia.
  • Kam PC; Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Anaesth Intensive Care ; 48(4): 277-288, 2020 Jul.
Article en En | MEDLINE | ID: mdl-32777929
ABSTRACT
Strabismus correction surgery is the most common eye operation in children. Adults have approximately a 4% lifetime risk of developing strabismus. Current treatment options include pharmacological injection of botulinum toxin or bupivacaine, conventional corrective surgery, adjustable suture surgery and minimally invasive surgery. Repeated surgery is common as each operation has a 60%-80% chance of successful correction. The benefits of early surgical correction in large-angle strabismus in children outweigh the risks of anaesthesia. General anaesthesia is suitable for patients of all age groups, for complicated or repeated surgery, and bilateral eye procedures. Regional ophthalmic block reduces the incidence of oculocardiac reflex and emergence agitation, and provides postoperative analgesia, but requires a cooperative patient as many experience discomfort. Topical anaesthesia has been used in pharmacological injection, minimally invasive surgery, uncomplicated conventional strabismus surgery and some adjustable suture strabismus surgery. Its use, however, is only limited to cooperative adult patients. Prophylactic antiemesis with both ondansetron and dexamethasone is recommended, especially for children. A multimodal analgesia approach, including paracetamol, intravenous non-steroidal anti-inflammatory drugs, topical local anaesthetic and minimal opioid usage, is recommended for postoperative analgesia, while a supplementary regional ophthalmic block is at the discretion of the team.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos Oftalmológicos / Estrabismo / Anestésicos Tipo de estudio: Diagnostic_studies Límite: Adult / Child / Humans Idioma: En Revista: Anaesth Intensive Care Año: 2020 Tipo del documento: Article País de afiliación: Australia

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos Oftalmológicos / Estrabismo / Anestésicos Tipo de estudio: Diagnostic_studies Límite: Adult / Child / Humans Idioma: En Revista: Anaesth Intensive Care Año: 2020 Tipo del documento: Article País de afiliación: Australia